Differential Determinants of Past Behavior and Future Intention Regarding Voluntary Blood Donation: A Cross-Sectional Study of Knowledge, Attitudes, and Practices in Qingdao, China
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Background
A persistent gap between motivation and action threatens voluntary blood supply. This study examined the public’s knowledge, attitudes, and practices (KAP) regarding blood donation, with a particular focus on identifying the different determinants of past blood donation behavior and future willingness to donate.
Methods
Convenience sampling was used to conduct a cross-sectional survey among 1,058 eligible people in Qingdao, China, between July and November 2025. Data were collected via a self-designed KAP questionnaire. To find independent characteristics linked to previous behavior and future intention, respectively, multivariable binary logistic regression was used.
Results
Overall, 37.0% of participants (n=391) had a lifetime donation history, while 39.2% (n=415) intended to donate in the next 12 months. Past behavior was positively associated with older age (36–45 years: OR=6.84; 95% CI: 3.21–14.58), higher education (OR=2.06; 95% CI: 1.33–3.17), and interpersonal interaction channels (OR=1.45; 95% CI: 1.01–2.09) but hindered by safety concerns (OR=0.23; 95% CI: 0.16–0.34). Conversely, future intention was positively correlated with male sex (OR=1.69; 95% CI: 1.24–2.29), prior donation history (OR=2.69; 95% CI: 1.87–3.86), having family members or friends in need of blood (OR=2.75; 95% CI: 1.96–3.85), and traditional media exposure (OR=3.33; 95% CI: 2.18–5.10). Higher education was adversely correlated with future intention (OR=0.55; 95% CI: 0.38–0.79).
Conclusion
There is a substantial disparity between donation motivation and action. The determinants of past behavior and future intention are asymmetric, suggesting that stage-specific interventions are required, using social mobilization for initiating first-time donations, while employing family reciprocity and authoritative communication to sustain long-term engagement.
Author summary
In this study, we investigated the knowledge, attitudes, and practices regarding voluntary blood donation among 1,058 eligible adults in Qingdao and found a notable “high motivation, low participation” paradox. More importantly, by contrasting logistic regression models, we identified that the determinants of past behavior and future intention are asymmetric—for instance, interpersonal interactions act as “initiating factors” for past behavior, while family reciprocity and traditional media exposure serve as “situational triggers” for future intention. These findings may provide actionable evidence to inform stage-specific, targeted recruitment and retention strategies, moving beyond traditional one-size-fits-all approaches. It directly addresses a critical global public health challenge, sustaining the voluntary blood supplyand provides practical insights for public health policy and intervention design.
